| NPI | 1104247329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE MANUEL TORREBLANCA Owner 323-588-2186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2015-12-21 |